Newest IVF Phenomenon: Girl Could Give Birth to Her Half-Sibling

July 5, 2007

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"This case is less distressing than some situations involving assisted reproductive technology," said Kathleen Powderly, acting director of the Division of Humanities in Medicine at SUNY Downstate Medical Center. "This one is not going to push as many buttons as some others -- like the mother who wanted to harvest the sperm from her brain-dead son to either have a baby herself or hire a surrogate."

Predicting a Stir

Still, the unusual nature of the situation prompted the team performing the donation procedure to refer the case to an independent ethics committee before going through with it.

"It was approved because she was doing it out of love for her daughter," said Dr. Seang Lin Tan, a professor of obstetrics and gynecology at McGill University in Montreal. Tan led the team that extracted and froze Melanie's eggs and reported the procedure at the European Society of Human Reproduction and Embryology conference in France this week.

There is no guarantee that the eggs will ever be used by Flavie, however. If Flavie decides that she wants to use her mother's eggs in the future, Tan says she must appear before yet another ethics committee.

Alternatively, according to Canadian regulations, she can choose to exchange the eggs with those donated by other women to get an egg that bears no genetic similarities to those of her mother. Women receiving Melanie's eggs would not be at increased risk of having a child with Turner's syndrome, fertility experts say.

But if Flavie decides to use her mother's eggs and if she manages to give birth, will the fact that the child is her own genetic half-sibling run counter to societal norms?

"That, obviously, is the important point in all of this," Tan said. "I don't think anyone has the 'right' answer to this."

He notes, however, that societal values and norms will change over time -- meaning that interpretation of the procedure 20 years from now could be much different than that of today.

"After all, it was only 20 years ago that homosexuality was illegal in Canada. Ethical norms evolve with time and change as time goes on."

Dr. Tommaso Falcone, the director of the Cleveland Clinic's Reproductive Endocrinology Research Laboratory, says moral concerns should be at least partially assuaged by the fact that many women have already donated their eggs to their sisters without ill social effect.

"Scientifically, this is simply [a] donor egg [procedure]. There is no scientific novelty. It is the ethical novelty -- somewhat -- in that the mother gave the eggs," he said.

Doctors Debate Viability

But Falcone adds that the logistics of using an egg that has been frozen for 20 years or more may prove to be a difficult hurdle.

"What is not stated is the very low pregnancy rate from this procedure," Falcone said. "Even in the best hands … it is probably no better than 5 [percent] to 6 percent."

Tan notes, however, that his lab can ensure a frozen egg survival rate of more than 85 percent -- pregnancy rates from similar procedures have approached 40 percent, making the option nearly as viable as natural pregnancy.

But only time will tell whether the eggs will still be viable after 20 or more years of cold storage.

"Obviously we don't know for certain," Tan said.

It is this variable of the equation that ethicists say may present the most significant ethical consideration.